University of Plymouth

PEARL https://pearl.plymouth.ac.uk
Faculty of Health: Medicine, Dentistry and Human Sciences School of Nursing and Midwifery

Interpretive, hermeneutic
phenomenology and ethnographic
principle of cultural interpretation with
Malaysian nurses

Arunasalam, N
http://hdl.handle.net/10026.1/10615

Nurse Researcher
RCN Publishing

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 Interpretive, hermeneutic phenomenology and ethnographic principle
of cultural interpretation with Malaysian nurses
Dr Nirmala (Mala) Arunasalam
University of Plymouth

Abstract
Background This paper draws on a research study conducted with Malaysian nurses
who studied on part-time Transnational Higher Education post-registration top-up
nursing degree programmes provided by one Australian and two UK universities. The
interpretive paradigm and hermeneutic phenomenological design are the most popular
methods used in international cross-cultural research in health care, nurse education
and nursing practice. Their inherent appeal is that they assist researchers' to explore
lived experiences. The ethnographic principle of cultural interpretation was also used
to provide meaning, clarity and insight.
Aim To examine the use of interpretive, hermeneutic phenomenology and
ethnographic principles of cultural interpretation in this research study.
Discussion To enable the researcher to undertake international cross-cultural
research and illuminate Malaysian nurses' views for the reader, some key factors need
to be considered. This is because cultural aspects will influence the information
participants' provide. Useful strategies that western researchers' can adopt to co-
create the research text with interviewees are outlined. The paradigm and research
designs used revealed the views and experiences of Malaysian nurses.
Conclusion Interpretive, hermeneutic phenomenology enabled exploration of
participants' experiences, whilst the ethnographic principles of cultural interpretation
allowed the researcher's reflexivity to provide emic and etic views for the reader.
Implications for practice This paper adds to the discussion on the paradigm and
research design for international cross-cultural research in the Asian region. It
identifies the influence participants' cultural values have on their confidence and level
of disclosure towards western researchers'.
Keywords: Interpretive, hermeneutic phenomenology, ethnography, cultural
interpretation, nursing research, research design.

Introduction

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Western countries collaborate mainly with Asian countries to provide Transnational
Higher Education (TNHE) post-registration top-up nursing degree programmes as
there is limited part-time delivery of these types of degrees in Malaysia. Further, there
is also recognition of the opportunity to attain western expertise, innovation and
degrees. In the ‘flying faculty’ models of TNHE post-registration top-up degree
programmes, academics ‘fly in’ from their country for one to two weeks to deliver
teaching and then ‘fly back’ to their country and academic roles.

International cross-cultural research is essential to evaluate the TNHE programmes

provided in Malaysia because hidden strong cultural factors influence the mind-sets,
and impact on the conversations and behaviours, of Malaysians. In this study, the
programmes were provided by one Australian and two UK universities (Arunasalam,
2013; 2016). Schutz (1976: 104) states, “every social group … has its own private
code, understandable only by those who have participated in it”. Thus, to undertake
research with Malaysian nurses, some key factors need to be recognised.

This paper outlines the rationale for choosing the paradigm and research designs. It
also identifies influential aspects and strategies that may be adopted.

Interpretive paradigm
In research, a paradigm infers to a pattern, structure, tradition, approach, model, frame
of reference, body of research and methodology and could be seen as a framework
for observation and understanding (Babbie, 2011; Creswell, 2013). The paradigm
chosen was influenced by the research aim to explore Malaysian nurses’ perspectives
of their intercultural teaching and learning experiences in the TNHE programmes. This
was because individuals encounter and view the same situation differently.
Participants’ meaning making of their experiences will be based on their own stances
and backgrounds.

Denzin & Lincoln (2011) stress that the interpretive paradigm focuses on the shared
patterns of meaning in the participants’ experiences with the researcher. The
researcher reveals these and articulates an explicit description of the individual, and
cultural and societal expectations (Arunasalam, 2016). Within the interpretive

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paradigm, there are several design approaches, such as phenomenology,
ethnography and case study.

Research Design
A research design is a plan of exploration that fits with the theoretical framework and
aims of the research study (Bradshaw and Stratford, 2010). The researcher uses their
presumptions to determine and draw conclusions to create understanding, as opposed
to predicting behaviour (Cohen, Manion & Morrison, 2011). A people-centred
approach was sought to identify nurses’ views. This approach also supported the
researcher’s self-reflexivity and enabled them to be part of the research.

A phenomenological approach was initially considered as the focus of this study was
everyday experiences and personal journeys. Van Manen (2014:14) described
phenomenology as “… the essence of phenomenon is universal which can be
described through a study of the structure that governs the instances or particular
manifestations of the essence of that phenomenon”. In looking into phenomenological
research, the emphasis is also on uncovering participants’ narrative accounts and any
concealed meaning embedded in their words. Van Manen (2014:48) states this as the
phenomenological text being “…descriptive; as it names something. And in the
naming, it points to something and it aims at letting something show itself.” However,
presumptions based on previous research, pre-reflective understandings and views of
the researcher must be “bracketed out” Husserl (1964: 9). This will enable the
participants’ voices to speak for themselves instead of being a reflection of the
researcher’s views. Although the findings will be informative, it conceals the
researcher’s valuable views, experiences and understandings.

In reality, bracketing out the researcher’s interpretation of the phenomena under study,
is difficult as Merleau-Ponty (1962: 5) believed: “we are caught up in the world and we
do not succeed in extricating ourselves from it in order to achieve consciousness of
it”. Bourke (2014) agrees the researcher cannot avoid their own views influencing
their judgement. However, not acknowledging the researcher’s own contextual and
personal frames of reference as a Malaysian and a UK resident, previous international
student nurse, UK-trained and based nurse, academic and researcher would affect
the validity of this research. The use of the researcher’s preconceptions is different in

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various designs e.g. phenomenology and hermeneutic phenomenology. For this
study, it was acknowledged that exploring, understanding and interpreting the
researcher’s experiences and views would support the authenticity of the explanations
of the text. This led to the hermeneutic phenomenological approach, informed by the
work of Max van Manen (2014) being considered.

Hermeneutic Phenomenology
Within hermeneutic research, the participants reflect and reconsider the everyday
issues they observed and experienced. One-to-one or group interviews are used to
explore and gather participants’ views and meaning making. It is based on what is
said (Doody & Noonan (2013), what is said between the lines (Kvale & Brinkman,
2009) and silence (van Manen, 2014). A Malaysian researcher with familiarity and
understanding of the culture aspects would easily intermingle and become part of the
Malaysian social setting. According to Bergold & Thomas (2012), participants’
perceptions of who the researcher is will influence what they say.

Each participant’s perspectives represent the experiences of a group of individuals

within a particular setting. It must be recognised that Malaysians are conversant with
English. However, English is not their first language. Further, their spoken English
includes words from the languages used by the other ethnic groups’. If the nurses are
informed that only English will be used in interviews, they may present an appropriate
‘front’, (Goffman, 1959). This means the nurses will answer the interview questions
politely with the limited use of English words. Thus, informing them that both Bahasa
Malaysia (Malaysian language) and English would be used, will reduce their anxiety
and feelings of self-consciousness. It may lead to the nurses speaking in English
because they are not under pressure.

In Malaysia, the culture promotes agreement rather than critique (Baguley, Findlay &
Kerby, 2015; King, 2008; Abdullah & Koh, 2009), thus, a nurse may be reluctant to
criticise for fear of being judged. It may also be due to the past colonial influences,
idealised merits of western education and the perceived higher status of western
academics will influence the nurses when voicing their opinions to westerners. It is
because feelings of inequality are deep-rooted in Malaysian nurses’ minds. The
nurses may display the classic Malaysian ‘smile and silence’ attitude of withholding

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information, either as a protection or as being careful not to be frank on issues that
may be destructive or have a negative repercussion. However, as a Malaysian with
insights based on shared lived experiences, the researcher was able to cut across
ethnic lines by speaking in Bahasa Malaysia, using local slang and humour to
encourage participants to disclose confidential and revealing accounts that they may
not disclose to a non-Malaysian. Iphofen (2011) believes that the establishment of
trust for revealing information is a hidden dilemma that is decided by participants. The
sensitivity of the issues that were being explored in this study meant it was
questionable the Malaysian nurses would voice their perspectives to a detached
western outsider. This is because they had not been socialised into the group (Schutz,
1976).

The researcher’s reflexive experiences uncover personal insights and theories from
the literature. These were questioned when analysing interview extracts in order to
reveal and understand participants’ perspectives. In being reflexive, the researcher
also enables readers to see how their stance impacted the research process (Savin
Baden, 2013). Richardson (2013: 959) argues reflexivity provides authenticity as
“knowing the self and knowing the research subject are intertwined due to historical
and local knowledge”. Further, the opinions of nurses are enhanced by the
researcher’s self-reflexivity. It is because the data is interpreted either through nurses’
views or the cultural beliefs of Malaysian society or through the researcher’s views.

Hermeneutic phenomenology allows the use of interview extracts to reveal

participants’ views as they are connected with their political, social and cultural
backgrounds. The presentation of the findings also uncover the researcher’s values
and views as they interpret and reveal participants’ reality.

The participants also appeared reluctant to provide any developmental feedback. It

led to the researcher quickly reverting to the use of a gentler approach, with a
beseeching tone that Abdullah (1992: 8) calls “verbal seduction”. This was to
encourage participants to relate their experiences. In using this style, the ‘we’
orientation is enhanced as it allows interviewees to feel relaxed during their
communication.

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The researcher writes with an academic standpoint to develop understanding of the
meaning patterns. Personal, professional and researcher views and experiences are
integrated to provide a detailed research text for the reader.

Ethnographic principle of cultural interpretation

The hermeneutic phenomenology research design is central to this study but the
ethnographic principle of cultural interpretation with the emic and etic principle also
informed the research. Agar (2000: 19) stresses that “Ethnography is neither
subjective nor objective but interpretive, mediating two worlds through a third” to
enable “thick description” (Geertz, 1973: 3) for understanding. In ethnographic
studies, the researcher ‘lives like and lives with’ their sample population to study their
behaviour in everyday context (Maanen, 2011; Wolcott, 2008)

Hermeneutic phenomenology informed by an ethnographic principle of cultural

interpretation is often chosen by researchers as they can position themselves as either
insiders and/or outsiders within their study. This enables the researcher to be
sensitive to societal values. To determine either the ‘insider’ or ‘outsider’ status, a
combination of dimensions must intersect such as the researcher’s identity (gender
and ethnicity), other features (age), time, location and the focus of the research,
personality and power relationships between the researcher and the participants who
are part of the research (Hayfield and Huxley, 2015. Umberson and Montez (2010:34)
stress that neither stance is privileged to see the “real truth as social experience and
perception are continuously created by the social actors”. The researcher uses their
reflexive views to connect with the shared experiences of the interviewees in order to
make sense of the meaning about participants’ and societal’ ways. This is to uncover
the reality of participants’ experiences. As communication and language are
intertwined, the ethnographic principle of cultural interpretation was used as it allows
participants experiences to be understood through their communication and shared
meanings within a culture (van Manen, 2014).

This allows the researcher to use an academic stance to develop meaning patterns of
views to provide a thorough interpretation. It will also enable the reader to understand
how the explanations of social meaning are part of a system of shared beliefs.

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Researchers often position themselves as either insiders or outsiders as it enables
critical inquiry throughout the research process. It acts as a sign-post of the decision-
making undertaken in the research to make it transparent to the reader. The insider
is someone whose biography (gender, race, etc), some intrinsic and some not, has
insight of the deep-rooted cultural characteristics related to members of the group
being researched. It enables a valid emic description. In contrast, researchers who
are not familiar with the entrenched cultural aspects of the group, community and
environment being researched and must rely on theories and perceptions are
outsiders (Etherington, 2004). Succinctly, insiders “cannot escape their past” while
outsiders are “without a history” of the research setting (Schutz, 1964: 34).

The stance a researcher adopts within an interpretive hermeneutic phenomenology

and ethnographic principle of cultural interpretation study requires continual reflexive
mode. The hermeneutic approach allows exploration of experiences whilst the
ethnographic principle of cultural interpretation enables the researcher to provide an
insider’s view of participants’ values in order for readers or outsiders to understand
why participants perceive their experiences in that way. This enables biases and
assumptions to be considered, and the reasoning behind actions to be justified
(Denzin & Lincoln, 2011). The researcher’s identity, beliefs and experiences were
ingrained and influenced decision-making throughout the research. Mainly, the
sharing of experiences was to encourage nurses to contribute further. This is in line
with Agar’s (2000: 251-252) tactics for cultures where “interpersonal harmony,
implicitness and understatement are valuable”.

Co-creating the research text would ensure the researcher would not dominate the
interpretations, or alter perceptions of the data collected, or the choices around
including or excluding the nurses’ and the researcher’s views to provide both an emic
and etic perspective for the reader. The decisions made with regards to which
interview extracts to use were valuable. This was because the reader would have to
see directly the nurses’ contributions in order to appreciate how their beliefs, behaviour
and experiences were influenced by their cultural backgrounds.

Conclusion

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In this study, the interpretive paradigm allowed the shared patterns of meaning in the
participants’ experiences to be addressed. Hermeneutic phenomenology allowed
Malaysian nurses to reflect on their TNHE experiences whilst it enabled the researcher
to be part of the research. The ethnographic principle of cultural interpretation that
also informed the study enabled the researcher to position their self as an insider
(knowledge and understanding of the community to allow privileged access to
participants) or outsider (experience the setting under study as a visitor to create a
detached view for readers). The key aspects and approaches that should be
considered when undertaking an interpretive, hermeneutic and ethnographic principle
of cultural interpretation research with Malaysian nurses have been outlined.

Implications for research and practice

Personal insights both as a Malaysian and resident of the UK privileged the researcher
by enabling understanding and interpretation of the Malaysian nurses views and
experiences in order to enhance the findings for the reader. In an increasingly
globalized economy, the impact of intercultural exchange has grown to show us
difference, to widen knowledge. This adds to the discussion on the paradigm and
research design for international cross-cultural research. It is pertinent that
researchers are aware that cultural aspects will influence participants, their confidence
and level of disclosure to westerners and implement the approaches outlined. This
research which is based within the researcher’s own social identity group provided
insight when considering the TNHE context which does not give attention to the
cultural disparities between western providers and the Asian society.

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